I gave birth twenty years ago. Because of the position of my daughter during the birth, with her elbow up beside her head, I sustained a fourth degree tear. My perineum was repaired twice, but I have had faecal incontinence since then. The tear took months to heal and was infected and very painful. I had to avoid fibre in my diet, wear a pad at the back every day, always be near a toilet, and even then, could not walk or sit without pain. It affected every part of my life. A year ago I started eating ketogenically to lose weight (low carb: mostly meat, vegetables, eggs, and cheese). I lost a lot of weight (much needed), but it also had the unexpected effect of easing most of my symptoms from the perineal tear! I rarely have “accidents” now, and it is so freeing to be able to confidently walk, sit on a white chair, wear light-coloured clothes, not worry about being away from a bathroom, and not have pain! I wanted to post here for the first time in case it helps anyone going through the same thing.